| NPI | 1336392935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE D HEITKAMP Director 618-367-2194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180006995) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2008-11-05 |